Ketones are a form of acid produced by the liver as fuel when blood sugar levels are too high or too low. Ketones are excreted in the urine, so a urine test and blood test are performed to test for ketones. However, for convenience, the urine ketone test is widely used. To diagnose and monitor diabetic ketoacidosis, a serious complication of diabetes, it is necessary to measure ketones in the body.
◇ One-line summary of the ketone test
It is a test that measures the amount of ketones in urine or blood.
◇ What kind of test is it?
When fatty acids are metabolized and ketones are in the blood, ketosis is initially induced. It then progresses to ketoacidosis, a form of metabolic acidosis. This condition is an emergency that is observed in patients with type 1 diabetes when their blood sugar is out of control.
There are three types of ketone bodies: acetoacetate, acetone, and beta-dehydrogenbutyrate. In severe diabetic ketoacidosis, beta dehydrogenbutyrate is mainly observed.
There are no special preparations before the blood ketone test. There are two main methods. There is a method to test acetoacetate with serum by collecting venous blood from the arm, and a method to test beta dehydrogenbutyrate, which measures whole blood collected by pricking a finger in the office with a palm-sized pocket monitor.
◇ Who and when should I receive it?
The presence of ketones in the urine of diabetic patients is a warning sign. Therefore, patients with type 1 diabetes, gestational diabetes, type 2 juvenile diabetes mellitus, and type 2 diabetes patients with a fasting blood sugar of 240 mg/dL or higher should be tested for ketones. In addition, even non-diabetic patients should be tested if they show symptoms related to ketosis or ketoacidosis.
◇ Interpretation of ketone test results
– Normal findings: 0.2~5mM
“Your blood ketone levels are low.”
It means that there is no excessive production of ketones or it is normal.
– Abnormal findings: more than 12mM
“You have high blood ketone levels.”
Indicates that there is some degree of ketosis or ketoacidosis. Signs of ketoacidosis include increased urination, excessive thirst, dehydration, loss of electrolytes, rapid breathing, a fruity smell when breathing, nausea, vomiting, fatigue, confusion, and coma.
Ketosis and ketoacidosis can also occur in conditions of starvation, alcoholism, and a high-fat, low-carbohydrate diet. In addition, blood gas tests, blood sugar and electrolyte tests are performed together to detect ketoacidosis in patients who are not diabetic but show signs and symptoms of diabetic ketoacidosis due to excessive alcohol consumption.
Ketoacidosis can cause very serious problems within a short period of time. Therefore, diabetic patients should be prepared to contact the hospital at any time if blood glucose test results are high or early symptoms of ketoacidosis appear.
Supervision = Hidak Consulting Doctor Seunghwa Lee (Seongnam City Medical Center Family Medicine Specialist)
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